Antifungals Flashcards
What are the similarities and differences of clotrimazole & tolnaftate vs fluconazole & terbinafine?
clotrimazole (candida + dermatophytes) & tolnaftate (just dermatophytes) - topical
fluconazole (broad) & terbinafine (onychomycoses) - systemic
Which cell wall synthesis inhibitor stops glucan synthesis and is administered systemically?
caspofungin
- used for life threatening infections that are unresponsive to older agents
What are the similarities and differences of nystatin vs amphotericin?
Both are cell membrane inhibitors by forming pores
nystatin - topical (only for candidiasis)
amphotericin - systemic (life threatening deep mycoses)
What drug is a nucleoside analog and inhibits nucleic acid synthesis?
flucytosine
What modification of antifungals has enabled them to be utilized systemically?
changing of structure so they are directed more specifically against fungal ergosterol (instead of mammalian cholesterol)
What are the adverse effects of trizoles (fluconazole) and allylamines (terbinafine) when used systemically?
rarely can cause hepatotoxicity
- drug interactions seen because of inhibition of CYP isoforms
What is the mechanism and use of terbinafine and tolnaftate?
inhibits squalene epoxidase
use: dermatophytoses (tolnaf is topical, terb is PO)
